不同心脏起搏方式对左室收缩功能的影响

Applying echocardiography to assess the effects of different pacing modes on left ventricular systolic function

目的应用超声心动图方法探讨不同心脏起搏方式对左室收缩功能的影响，选择30例置入DDD起搏器的病窦综合征患者。将起搏方式由DDD随机程控为VVI，AAI模式，观察左室收缩功能指标；每次测量间隔5min以上。结果VVI起搏时左室收缩功能最差，与AAI和DDD起搏相比，VVI起搏时收缩功能标：SV，CO，EF均明显降低，而ESV明显增大。与DDD起搏相比，AAI起搏时SV，CO，LVEF均明显增大。结论房室同步和心室同步对左室收缩功能均有重要影响；病窦综合征患者，加强心室起搏管理，在提供双腔支持的安全前提下，以AAI（R）模式作为基本治疗模式，减少右心室起搏，对改善患者的左室功能有重要意义。

Objective Applying echocardiography to assess the effects of atrioventricular synchrony and ventrieular activation sequence on left ventrieular systolic function. Methods 30 Sick sinus syndrome （SSS） patients with dual-chamber pacemakers were included in the study. Pacemakers were programmed in random order to three different pacing modes：AAI,DDD or VVI. Applying echoeardiography to measure left ventricular systolic function targets. A period of 5 minutes was allowed for each measurement. Results Comparing with DDD and VVI, AAI increased EDV, SV, CO, LVEF significantly （ P 〈 0. 05 ） ; Comparing with VVI, DDD increased SV,CO and LVEF significantly（P 〈 0. 05 ）. Conclusion Left ventrieular systolic function was affected greatly by atrioventricular synchrony and ventrieular activation squence. It is important to preserving atrioventrieular synehrony and normal ventricular activation squenee in cardiac pacing. It is important to select AAI（R） pacing as a basic model for patients with Sick sinus syndrome that preserve the left ventricular systolic function.